Providing technical assistance and assessing the capacity of American Indian/Alaska Native injury prevention programs

Background: This presentation summarizes efforts to provide technical assistance (TA) to and assess capacity building achieved by 30 Tribes/Tribal Organizations participating in the Indian Health Service Tribal Injury Prevention Cooperative Agreements Program (TIPCAP) from 2000-2005. Methods: TA was provided and site progress assessed through: document review; on-site visits; conference calls; and multiple surveys. Data collected annually was summarized across five program components, for which composite measures were developed: 1) support; 2) staffing; 3) management; 4) intervention activities; and 5) degree of progress. An overall site summary measure was developed (advanced, intermediate, basic) to allow comparison within and across sites. Results: TA included workshops, newsletters, and tools to enhance IP capacity (e.g., reporting templates; planning worksheets; seatbelt use observational protocol). Most common IP issues addressed by sites included unintentional injuries (motor vehicle crashes, fires, and falls), with primary intervention approaches focused on education and equipment distribution, with some policy/enforcement activities. Across TIPCAP sites, average capacity scores for program support and staffing measures were highest (79% and 70%, respectively); intervention activities and degree of progress were 56% and 52%, respectively, and the average score for management was lowest (38%). For the overall measure, eight sites (27%) were advanced, 17 (59%) were intermediate, and four (14%) were basic. Conclusions: Rapport and trust are necessary for comprehensive TA. Clear, consistent, and shared communication among local coordinator, project officer, headquarters, and external monitors is needed for program success. Additional support is needed to ensure comprehensive objectives, use of multi-level approaches, and evaluation data collection.